Hysterectomy inquiry reveals 25-year scandal of silence

A rogue consultant removed the wombs of 129 women because his work went unchallenged for almost a quarter of a century, according to a report into one of Ireland's worst medical scandals.

The findings of an investigation into abnormal maternity unit practices at Our Lady of Lourdes hospital in Drogheda triggered calls for fundamental reforms of hospital procedures in the republic.

Mary Harney, who is both deputy prime minister and minister for health and children, said: "This is a damning report and it is clear from the findings that many lessons need to be learned and changes made to ensure that such events do not happen again in Irish hospitals. [We need to ensure] that consultants work in teams with clear clinical leaders who will ensure that individual clinical practice is in line with best practice."

The 250-page document follows a two-year investigation by Judge Maureen Harding Clarke. The obstetrician at the centre of the affair, Dr Michael Neary, was struck off Ireland's medical register three years ago after being found guilty of professional misconduct.

The inquiry exposed a culture of obedience accorded to long-established consultants. For decades the high level of hysterectomies in Drogheda went almost without criticism. It was, according to the report, the unit's practice to remove a woman's womb if she experienced heavy bleeding after delivering a baby by caesarean section.

Such drastic surgery is nowadays considered a last resort. Most obstetricians perform fewer than 10 hysterectomies throughout their careers. At Our Lady of Lourdes, 188 peripartum hysterectomies (operations performed within six weeks of birth) were conducted between 1974 to 1998. Dr Neary alone carried out 129.

The rate of hysterectomies in that period was one for every 37 caesarean sections; at similar Irish hospitals it was about one for every 254. The numbers of operations carried out by Dr Neary in the late 1970s did trouble one matron but her concerns went unheeded.

A review by the Royal College of Obstetricians and Gynaecologists failed to highlight problems at the unit.